[2] However, according to Esmaelilzadeh, et al. there is no widely accepted protocol to manage a brain dead mother "since only a few reported cases are found in the medical literature.
[2] According to Esmaelilzadeh, et al., "[a]t present, it seems that there is no clear lower limit to the gestational age which would restrict the physician's efforts to support the brain dead mother and her fetus.
Absent from the legislation are specifics as to how the law should be applied depending on how far along a woman is in her pregnancy, as well as the definition of terminally ill versus brain dead.
[9] This Texas law does not specifically detail a hospital's obligation in the case when a pregnant woman is brain dead, thus leading to the long-drawn legal battle that ensued in the weeks following Marlise Muñoz's pulmonary embolism.
[12] The cost of maintaining a brain dead mother on life support depends on the number of days spent in the Intensive Care Unit (ICU).
[2] The cost of a cesarean section, the recommended mode of delivery for brain dead pregnant women, is roughly $4,500 for physicians' fees alone, according to the Healthcare Bluebook.
[17] The most recent peer-reviewed investigation to note the overall cost of care for a viable child delivered from a somatically supported brain dead mother focused on the case of a child delivered via cesarean section in California on the 63rd hospital day at 31 weeks gestation, to a mother who was brain dead at 22 weeks gestation in 1983.
[19] The death of Marlise Muñoz at John Peter Smith Hospital in Fort Worth, TX was the most recently publicized instance of somatic support of a brain dead pregnant woman from 2013-2014.
2718 (c), that requires all hospitals to publish a list of their "standard charges", but the Department of Health and Human Services has not issued a rule to implement that provision.
[25] Drawing upon the principle of beneficence, Dillon et al.[26] and Loewy[27] propose the following rubric when determining whether or not to offer life support to a pregnant, brain dead woman: A second view considers the autonomy of the mother and her right to die.
Without an advance directive stating that the woman wishes to be kept alive to save her unborn child, prolonging life is unethical.
[29] Finally, some ethicists have argued that there are no ethical dilemmas inherent in the case of a pregnant woman who is declared brain dead.
Keeping a medically declared 'brain dead' woman on life support to sustain a potentially viable fetus is a topic of considerable debate and controversy.
[30] There is heavy discourse between biomedical and legal experts regarding whether a dead person is "a dysfunctional incubator" to an unborn fetus.
These dispute government, state and/or religious institutional interventions to make decisions against an individual's own wishes, which they argue renders advance directives meaningless and fails to protect women.